An anastomotic joint is the connection between two body vessels that allow fluids to pass between the two body vessels. Essentially, an anastomotic joint is a communicating opening. Examples of natural anastomotic joints include the connection between the bladder and the urethra, between blood vessels, and the junctions at the different segments of the gastrointestinal track.
Surgical anastomosis is a man made connection between two body structures. It usually means a connection that is created between tubular structures, such as blood vessels, loops of intestine, or ureteral tract. Often surgical anastomosis is conducted to reconnect parts of the body that should be in fluid contact, for example where a segment of the intestine is resected the two remaining ends are rejoined. Similarly, as the prostate surrounds the upper urethra removal of the prostate will require reconnection of the bladder and the urethra. In addition to the open surgery, a few new types of surgery such as laparoscopic prostatectomy and robotic-assisted prostatectomy were also developed in recent years. However, removal of the prostate leaves a gap between the urethra and the bladder neck. The present practice for anastomosis is hand sewing or robotic arm sewing. Not only is this procedure technically difficult, it requires about 45 minutes operating time for clinicians, whereby the connection is unstable, insecure and increases the risk of infection requiring longer external catheterization of the patient. The patient needs to be cathatarised to avoid the fluid passage between the two body parts coming into contact with the sutured wound before is has a chance to grow together and heal.
Surgical anastomosis is technically difficult; an issue known in 1902 when Alexis Carrel formulated four main guidelines for surgical anastomosis: 1) avoid luminal narrowing at the anastomotic site, 2) avoid the creation of folds and a rough inner surface of the vessel, 3) a need to oppose the two intimal edges closely, and 4) eliminating contact of suture material with blood.
After 100 years, the needle and thread are still used for the anastomosis. Suturing, however, has several detrimental aspects. The penetrating needle induces vascular/organ wall damage, which influences the healing response. The patient needs to be cathatarised to avoid the fluid passage between the two body parts coming into contact with the sutured wound before is has a chance to grow together and heal. Although, many attempts have been made to reduce the damage to the wall by using non-absorbable suture materials (cotton, nylon, stainless steel), absorbable sutures (catgut, polyglycolic acid, polydioxanone, polyglactin), or the atraumatic needle it is difficult to minimize wall damage. Currently, the only way to reduce or minimize wall damage is by the surgeons skill which is highly individualistic and damage cannot be eliminated entirely by such means.
An object of the invention is to ameliorate at least some of the problems listed above.